The Forgotten Workforce: The 20–50% We’re Not Talking About
Every employer has them, the employees who show up every day, keep operations moving, and yet, when it comes to benefits, are almost invisible.
They’re the part-timers, the hourly workers, the people who waive major medical because they simply can’t afford the payroll deduction. In most groups, this forgotten workforce represents 20–50% of all employees.
And as brokers, it’s time we start asking a simple but powerful question:
👉 What are we doing for the employees who aren’t enrolled in anything?
The Invisible Segment of Every Group
Let’s take a real-world example.
A regional manufacturing company in Texas has 260 employees. During open enrollment, 120 enroll in the company’s major medical plan. The other 140? They waive coverage.
Why?
Because $180 per paycheck — even for “affordable” coverage by ACA standards — feels impossible for a worker earning $17 an hour.
So half the workforce walks away uninsured.
No protection, no access to preventive care, no connection to the company’s benefit program.
From a compliance standpoint, those employees still matter.
From a human standpoint, they matter even more.
The Missed Opportunity — and Risk
Most brokers don’t intentionally ignore these employees. The truth is, our industry has been conditioned to focus on the enrolled — the “qualified participants.”
But here’s the cost of that mindset:
Employers remain exposed to ACA §4980H(a) penalties for not offering coverage to at least 95% of full-time employees.
Employees who waive often feel excluded, fueling higher turnover and lower morale.
Brokers miss out on organic growth — the revenue that’s already sitting inside their existing book of business.
At Evolved Benefits, we see this pattern every day. When we analyze employer groups with high waiver rates, we consistently find two things:
They’re not out of compliance yet, but they’re on the edge.
They have a workforce ready and willing to engage — if the coverage fits their budget.
That’s where MEC comes in.
Why MEC Exists
Minimum Essential Coverage (MEC) plans were never designed to replace major medical. They were designed to complete a benefits strategy.
MEC satisfies the employer’s obligation under the ACA’s “A” penalty, ensuring every full-time employee is offered affordable coverage.
But more importantly, MEC provides access — preventive care, telemedicine, and basic health services — to those who’ve historically been priced out.
For employers, it’s compliance protection.
For employees, it’s inclusion.
For brokers, it’s opportunity.
And yet, it’s the most under-discussed and under-utilized tool in our industry.
A New Way to Think About Your Clients’ Populations
Here’s what happens when a broker starts looking beyond the enrolled:
A staffing company with 800 employees implemented an Evolved Benefits MEC plan last year after realizing 380 of their workers had no coverage at all.
Those 380 employees now have preventive care and telemedicine. The employer gained ACA protection. The broker increased revenue — without adding a single new client.
That’s what happens when you start thinking about the whole workforce, not just the enrolled one.
Culture, Compliance, and Care — The New Broker Equation
Heading into Q4 2025, the most successful brokers will be the ones who:
Ask better questions — Who’s not enrolled? Why? What would it take to change that?
Educate their clients — on compliance exposure and real-world affordability.
Offer tiered solutions — like MEC and MV plans that meet employees where they are.
At Evolved Benefits, this is the lens we use every day. We’re helping brokers protect their clients from penalties, reach more employees, and grow their agencies organically — simply by addressing the segment most people overlook.
The Takeaway
This isn’t about selling another product. It’s about seeing the people who’ve been invisible in the benefits conversation for too long.
Because every waived employee is a missed opportunity — for the employer, for the broker, and for the employee themselves.
As you move through Q4 2025, take another look at your groups.
Pull the waiver lists.
Ask your clients that one powerful question again:
“What are we doing for the employees who aren’t enrolled in anything?”
You might be surprised at what you find, and how much opportunity has been sitting there all along.